Effect of intraoperative heat preservation nursing in prevention of hypothermia and complications in patients undergoing gynecological laparoscopic surgery
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摘要:目的 探讨术中保温护理措施对妇科腹腔镜手术患者低体温及并发症的预防效果。方法 将本院接受妇科腹腔镜手术的96例患者随机分为对照组(n=48)和干预组(n=48)。对照组给予手术常规护理, 干预组在对照组基础上给予术中保温措施。监测2组术前、术中60 min和术后30 min的鼻咽温度、心率(HR)和收缩压(SBP)、舒张压(DBP)变化，并观察2组低体温和手术相关并发症的发生率。结果 2组手术时间、腹腔冲洗液量、入室后术前鼻咽温度、HR、SBP、DBP比较差异均无统计学意义(P>0.05); 干预组术中出血量、麻醉清醒时间优于对照组，术中60 min、术后30 min鼻咽温度高于对照组, HR、SBP、DBP低于对照组，围术期低体温、苏醒期躁动和寒颤发生率低于对照组，差异均有统计学意义(P＜0.05)。结论 系列保温护理措施能减少术中出血量，缩短麻醉苏醒时间，有效预防围手术期低体温和并发症的发生。Abstract:Objective To explore the effect of intraoperative heat preservation nursing in prevention of hypothermia and complications of patients with gynecological laparoscopic surgery.Methods A total of 96 patients who underwent gynecological laparoscopic surgery in our hospital were randomly divided into control group (n=48) and intervention group (n=48). The control group was given routine nursing, and the intervention group was given intraoperative thermal preservation measures on the basis of the control group. The changes of nasopharyngeal temperature, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored at 60 min of intraoperation and 30 min after operation, and the incidence of low body temperature and complications were observed.Results There were no significant differences in operative time, abdominal lavage volume, preoperative nasopharyngeal temperature, HR, SBP and DBP between the two groups (P>0.05). The bleeding volume and awakening time of anesthesia in the intervention group were better, nasopharyngeal temperature at 60 min of intraoperation and 30 min after operation was higher, HR, SBP and DBP were significantly lower, the incidences of hypothermia, awakening restlessness and chills in the interventiongroup were significantly lower than those in the control group, the between-group differences were observed(P < 0.05).Conclusion Nursing measures of heat preservation during gynecological laparoscopic surgery can reduce intraoperative bleeding, shorten the recovery time of anesthesia, and effectively prevent the occurrence of low body temperature and related complications during perioperative period.
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表 1 2组手术情况比较(x±s)
组别 n 手术时间/min 术中出血量/mL 麻醉清醒时间/min 腹腔冲洗液量/mL 对照组 48 92.58±18.54 92.51±25.48 32.57±5.58 658.90±179.25 干预组 48 89.37±20.13 78.37±18.54* 28.29±4.16* 670.23±185.36 与对照组比较, *P＜0.05。 
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表 2 2组围术期鼻咽温度、HR、SBP、DBP比较(x±s)
监测指标 组别 术前 术中60 min 术后30 min 鼻咽温度/℃ 对照组 36.47±0.35 35.87±0.52 35.92±0.48 干预组 36.46±0.38 36.35±0.42* 36.32±0.43* HR/(次/min) 对照组 84.52±9.70 92.82±10.34 92.31±9.65 干预组 83.94±9.58 87.26±9.47 86.59±9.52 SBP/mmHg 对照组 124.58±12.07 132.87±10.83 134.28±10.50 干预组 125.17±10.95 128.08±10.17* 128.70±10.23* DBP/mmHg 对照组 82.14±6.35 88.91±6.46 88.78±6.73 干预组 81.79±6.29 84.75±6.17* 84.94±6.54* HR: 心率; SBP: 收缩压; DBP: 舒张压。与对照组比较, *P＜0.05。
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表 3 2组围术期低体温和相关并发症比较[n(%)]
组别 n 低体温 心率失常 苏醒期躁动 寒颤 低氧血症 对照组 48 15(31.25) 2(4.17) 9(18.75) 7(14.58) 3(6.25) 干预组 48 5(10.42)* 1(2.08) 2(4.17)* 1(2.08)* 0 与对照组比较, *P＜0.05。
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